Can coping strategies improve caregivers’ mental health?

Coping strategies therapy can relieve stress and anxiety in caregivers of dementia patients, and at no further cost than usual care. Researchers from the University College London in the United Kingdom enrolled 260 depression-free family caregivers in either an 8-session program called START – Strategies for RelaTives – or usual care including medical, psychological and social services for the patient with dementia. The START program was administered by non-clinically trained psychology graduates, who worked on a personal basis with family caregivers at home to identify issues and begin coping strategies, such as helping with accessing emotional support and relaxation.

At the same time, the researchers – led by professor Gill Livingston – assessed anxiety and depression with the Hospital Anxiety and Depression Scale (HADS) as well as cost-effectiveness for 24 months. The caregivers in the START group had a 2+ point improvement in their HADS score, as compared to the control group in both the short- and long-term. Moreover, START was not costlier than traditional care. Livingston said this “new cost-neutral program is an effective way to support carers and improve their mental health and quality of life and should be made widely available.” Professor Sube Banerjee of the University of Sussex added in a linked comment that the program should be accessible “to all family carers of people with dementia as part of the support with a timely diagnosis.”

There are about 670,000 dementia caregivers in the UK, and more than 15 million in the United States. Dementia is an umbrella term that includes Alzheimer’s disease, vascular dementia, mixed dementia, Lewy body dementia, frontotemporal dementia, and others. Alzheimer’s alone is the 6th leading cause of death in the United States, and leads to memory, thinking, behavior problems, and other symptoms. This makes caregivers a fundamental part of the patient’s life.

Now, dementia is not contagious, but that does not change the fact that approximately 40% of the family caregivers who provide care for a loved one who is mentally ill end up experiencing depression or anxiety. As a result, the patient may have to be moved to a care home. “Worldwide, there are an estimated 44 million people with dementia, and this figure is likely to double every 20 years,” Livingston said. “Too often, people forget the substantial effect dementia has on family members caring for relatives with dementia. Policy frameworks assume that families will remain the main providers of their (unpaid) support.”